Diabetic peripheral neuropathy, pain, and acupuncture
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Diabetic peripheral neuropathy, pain, and acupuncture
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[post_date] => 2024-12-26 19:24:53
[post_date_gmt] => 2024-12-27 00:24:53
[post_content] => Practice Passage (Question 1-5)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
A researcher is interested in studying diabetic peripheral neuropathy, a disorder where long-term high blood sugar leads to peripheral nerve damage. Peripheral neuropathy can affect motor, sensory, and autonomic nerves, and symptoms vary depending on the nerves that have been damaged. The researcher specifically looks at sensory nerve damage, and how it can cause hypersensitivity to stimuli that are not usually painful. This type of neuropathic pain is incredibly difficult for patients to endure - it affects their emotional well-being, sleep, and overall quality of life. The researcher develops a study to test the effects of acupuncture on neuropathic pain. She recruits 100 patients who have been diagnosed with diabetic peripheral neuropathy, and randomly assigns them to the acupuncture group (n = 50) or a wait-list control group (n = 50). Individuals in the acupuncture group receive three 60-minute acupuncture treatments per week; individuals in the control group do not receive the treatment. The researcher gives every participant an ecological momentary assessment device (EMA), which goes off at random intervals throughout the day and asks patients to report on their pain symptoms on a scale of 1-10 (with 1 indicating no pain and 10 indicating extreme pain), as well as any other symptoms they are currently experiencing. Table 1 outlines the average weekly ratings of pain for each group over a one month period of time.
Table 1
[post_title] => Diabetic peripheral neuropathy, pain, and acupuncture
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[question] => The researcher examines the data from the acupuncture group and finds that differences between baseline and week 4 are statistically significant, but not clinically significant. What could this mean?
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[answer] => 3
[description] => Reason for the Correct Answer:
The comparison that the researcher made was within-group pre-and post-testing, not between. She did not compare the data of the treatment group to the control group.
Statistical significance refers to the probability that results were due to chance. The reduction in pain symptoms was statistically significant, so the impact of acupuncture was probably not due to chance.
Clinical significance refers to how much the treatment actually benefited the individuals in the study. While the results were statistically significant, ratings of pain at week 4 indicated that patients were still feeling an incredible amount of pain. This means that the researcher may not recommend acupuncture as having a significant benefit in pain reduction for this group.
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[0] => Array
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[each_answer] => A. The impact of acupuncture on pain is probably not due to chance, and acupuncture significantly improves how patients experience pain.
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[1] => Array
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[each_answer] => B. The impact of acupuncture on pain is insignificant when treatment and control groups are compared.
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[each_answer] => C. The impact of acupuncture on pain is probably not due to chance, but acupuncture does not significantly improve how patients experience pain.
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[each_answer] => D. The impact of acupuncture on pain is insignificant because the data is misleading and probably due to chance.
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[1] => Array
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[quiz_unique_key] => 3873426850
[question] => Many of the patients report feeling significant pain when a light blanket is draped over their legs. Which of the following describes the type of neuron that carries information about sensitivity to pain to the central nervous system?
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[answer] => 1
[description] => Reason for the Correct Answer:
Lower motor neurons carry information from the CNS.
Neurons that carry information from the CNS are efferent neurons. Lower motor neurons are efferent.
An afferent neuron carries information from the periphery into the central nervous system.
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[0] => Array
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[each_answer] => A. Afferent neuron
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[each_answer] => B. Proximal neuron
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[each_answer] => C. Efferent neuron
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[each_answer] => D. Lower motor neuron
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[quiz_unique_key] => 2261298308
[question] => When the researcher examines the EMA data, she notices that one patient in the study consistently reports that he feels as though his heart is racing and experiences rapid heart rate. Increased activity of which kind of neuron would usually increase the amount of blood pumped out of the heart?
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[answer] => 2
[description] => Reason for the Correct Answer:
Lower motor neurons cause skeletal myocytes to contract.
Parasympathetic neurons may decrease cardiac output.
Sympathetic neurons may increase cardiac output.
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[each_answer] => A. Parasympathetic
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[each_answer] => B. Sympathetic
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[each_answer] => C. Somatosensory
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[each_answer] => D. Lower motor neuron
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[quiz_unique_key] => 2377279144
[question] => Peripheral neuropathy is the most common type of diabetic neuropathy, but some patients also experience autonomic neuropathy. Which of the following symptoms is associated with autonomic neuropathy?
[value] => Array
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[answer] => 1
[description] => Reason for the Correct Answer:
Autonomic neuropathy does not impact a person’s affective state.
Loss of feeling in arms is associated with peripheral nerve damage, or peripheral neuropathy.
Inability to focus the eye is associated with focal neuropathy, or damage to one specific nerve.
Autonomic neuropathy affects the autonomic nervous system; it affects heart and blood vessels, the urinary tract, sex organs, sweat glands, the eyes, and lungs.
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[answers] => Array
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[0] => Array
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[each_answer] => A. Sharp decreases in blood pressure when standing
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[each_answer] => B. Loss of feeling in arms
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[each_answer] => C. Inability to focus the eye
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[each_answer] => D. Flat affect
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[quiz_unique_key] => 83407773
[question] => Why are patients randomly assigned to the different treatment groups?
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[answer] => 3
[description] => Reason for the Correct Answer:
Random assignment does not affect the reliability of an assessment.
Random assignment seeks to improve likelihood of equivalence between groups, not nonequivalence.
Random assignment is not random selection; random selection refers to how you choose your overall sample & whether or not they represent the population at large. Random sampling improves external validity.
Random assignment is related to internal validity. When individuals are randomly assigned to groups, it reduces the chance that the groups will be significantly different.
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[0] => Array
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[each_answer] => A. Increase external validity
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[each_answer] => B. Improve retest reliability
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[each_answer] => C. Increase internal validity
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[each_answer] => D. Improve likelihood of non-equivalence
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